2017 Summer Camp Registration Form
Please fill out this form to register for Gallatin Valley Farm to School's garden-based summer camps! Payment is due upon registration; you may submit it online at gvfarmtoschool.org/camps or by check. Make checks payable to Gallatin Valley Farm to School and mail them to:

Gallatin Valley Farm to School
PO Box 563
Bozeman, MT 59771

Contact Erin at erin@gvfarmtoschool.org or (406)219-7929 with any questions. We look forward to spending a week growing, harvesting, preparing and eating delicious food in the garden with your child this summer!

Child's Information
Last Name
Your answer
First Name
Your answer
Gender
Birth Date
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Grade Level (Fall 2017)
Address
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City
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State
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Zip Code
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Name of Child's School
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Medical Information
Allergies
Please provide any necessary details.
Your answer
Medications
Please provide any necessary details.
Your answer
Dietary Restrictions
Your answer
Other pertinent medical information or special needs?
Your answer
Primary Doctor & Contact Information
Your answer
Health Insurance Carrier
Your answer
Emergency Contact Name
Your answer
Emergency Contact Phone
Your answer
Parent/Guardian Information: Contact #1
Last Name
Your answer
First Name
Your answer
Relationship to Child
Primary Phone
Your answer
Alternate Phone
Your answer
Email
Your answer
Parent/Guardian Information: Contact #2
Last Name
Your answer
First Name
Your answer
Relationship to Child
Primary Phone
Your answer
Alternate Phone
Your answer
Email
Your answer
Program Information
The July 24-28 session of Garden Explorers Camp is now open to 1st, 2nd and 3rd graders. Contact erin@gvfarmtoschool.org to be added to the waitlist of the sessions that are filled.
Which camp session(s) will your child attend?
Required
Child's T-Shirt Size
How did you hear about Gallatin Valley Farm to School's Summer Camps?
Required
Is there anything else you'd like to tell us concerning your child's participation in this camp?
Your answer
Waiver and Release
Vehicle Permission: I grant Gallatin Valley Farm to School staff and volunteers permission to drive my child to teaching sites such as farms and gardens during the camp.
Required
Refund Policy: I understand that the program enrollment fee is nonrefundable unless cancellation occurs 30 days prior to the camp start date. For all cancellations prior to the 30 days there is a $30 nonrefundable administrative fee. Enrollment fee is transferrable with organization approval.
Required
Photo Release: I grant Gallatin Valley Farm to School and volunteers the right to take photographs of my child in connection with the camp. I agree that Gallatin Valley Farm to School may use such photographs of my child for any lawful purpose, including for example such purposes as publicity, illustration, advertising and web content.
Required
Waiver: I acknowledge that my child’s participation in this program involves being outdoors for the duration of camp time. Field trips to farms and activities in the garden may involve walking or running on uneven surfaces, bending or twisting, and exposure to heat and sun. Participants will also be touching plants, observing insects, and preparing homemade snacks on a daily basis. I am aware of the risks and hazards of participation in this program. I understand that my child’s participation in this program is voluntary and at my or my child’s own risk. I hereby release Gallatin Valley Farm to School, its volunteers and camp leaders from any liability resulting from my child’s participation in this camp. I authorize program staff to secure or provide emergency medical treatment if deemed necessary for my child’s immediate care.
Required
Enter your full name to serve as your electronic signature
Your answer
Date
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